Orbital cellulitis and abscess are emergencies which might compromise sight and in the extreme, even life. This usually occurs secondary to sinusitis, orthodontic infections, trauma to surrounding regions and intracranial infections. We are describing a rare case of orbital cellulitis which occur 1 month post trauma in a patient with no prior history of sinusitis. This 21 year old gentleman had a fall from height and sustained left infraorbital fracture and anterior maxillary fracture. He defaulted on his follow up.1 month after his fall, he presented with left eye swelling, fever and blurring of vision. He had foul smelling discharge from his nose for 1 week prior to his eye swelling. Ophthalmology assessment showed left eye proptosis, reduced movement in all directions, chemosis and raised intraorbital pressure. Ct scan confirmed the diagnosis of left periorbital abscess. Emergency endoscopic orbital decompression was done. Pus was drained from the maxillary sinus. The inferior rectus muscle herniated into the maxillary cavity. Muscle was reduced and orbital floor defect was splinted with a inflated Foley catheter. Post operatively patient intraocular pressure normalized and proptosis resolved. Patient recovered well with broad spectrum antibiotics for 2 weeks
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